Session 3E: Equitable access to quality midwifery

Presentations

The equitable access to quality midwifery session opened with a review of the objectives from Dr Luc de Bernis, UNFPA, who also provided an overview of the recently launched State of the World’s Midwifery 2014 report and associated Lancet midwifery series. Ms Petra ten-Hooper Bender, Integrare, presented the key findings from the two products, noting that at the core of the State of the World’s Midwifery 2014 report is the concept of ‘effective coverage’ which includes the dimensions of service availability, accessibility, acceptability, and quality. The report underscores that achieving effective coverage of childbirth services requires a comprehensive approach to midwifery training, deployment, retention and supervision that will ensure there are sufficient numbers of midwives with the skills needed to provide high quality care to all women. Attaining universal access to skilled delivery care also means countries must ensure well-functioning referral and supply chain systems are in place. Ms ten-Hooper Bender explained that the report includes two page profiles for 73 of the 75 Countdown countries which can be used, “to stimulate policy discussion on the midwifery work force and how well a country is doing in addressing the need for skilled birth attendants.” Dr de Bernis expanded on the use of the country profile tool for evidence-based decision making, and described how population dynamics place differing pressures on country health systems – countries where population growth is escalating and where fertility levels remain high will face increasing demand for services.

Following the presentations, Dr de Bernis asked each of the panelists their perception of the added-value of the State of the World’s Midwifery report and to reflect on how countries can best address their human resource challenges. Ms Frances Ganges, Chief Executive of ICM, emphasized how the new report has raised the profile of midwives and has provided needed evidence on shortages of this cadre across many high burden countries. She also stressed the importance of capacity building of health care professional associations so that they can effectively lobby and advocate for high quality midwifery care. Honorable Ahmad Jan Naeem, Deputy Minister of Afghanistan, explained how his country successfully introduced and rapidly scaled up community midwives as a key strategy for reducing maternal and newborn mortality. He cautioned that some of the gains Afghanistan has achieved in recent years could be in jeopardy as external resources for health start to decrease. The Honourable Minister of Health of Guinea concurred about the importance of the report and country profiles for stimulating needed dialogue on midwifery, and described the programs and incentives his country has put into place to increase the deployment of skilled midwives to the rural areas. Dr Eckhart Buchmann,, obstetrician practicing in South Africa, stressed the importance of strengthening partnerships between midwives and obstetricians – noting that both are essential to improving the quality of care and for making sure care is affordable.

Dr de Bernis closed the session after a brief question and answer session when audience participants and panelists discussed the importance of making sure midwives focus equally on the care of the mother and the care of the baby, strengthening individual health care professional associations as well as collaborations between them, and to better link training programs to evidence about skill needs on the ground.

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joins the reproductive, maternal, newborn and child health communities into an alliance of members, across seven constituencies. Working together, our goal is a world in which all women, newborns, children and adolescents not only are healthy, but thrive.